Women's Clinic in Singapore (Caring & Treating Since 2005)

Vaginismus (Unusual Vaginal Tightness)

What is Vaginismus?

Vaginismus is a condition in which penetration or attempted penetration of the vaginal canal results in involuntary contraction of the pelvic floor muscles around the vagina, resulting in pain and discomfort. These painful pelvic muscle spasms that occur are unintentional and women may be completely unaware altogether that this is happening.

What is abnormal vaginal discharge?

Under-diagnosed & under-reported female sexual problem

Women with vaginismus may find sexual intercourse or other activities like undergoing a pelvic examination in clinic difficult or completely impossible. The severity of vaginismus is a spectrum which varies between individuals. Most women affected may also experience a degree of fear and anxiety associated with the thought of penetration.

Vaginismus is a fairly common, likely under-diagnosed and under-reported female sexual problem which can occur to any woman. Women with vaginismus may feel alone or ashamed about their problem and hesitate to seek treatment, as they do not realise they have a very treatable medical problem.

Services Available:

Our clinics offer treatment for vaginismus in a stress-free and encouraging environment with female doctors, through a combination of the use of vaginal dilators and pelvic floor exercises and psychosocial interventions.

We provide a private and discreet environment for you to discuss your medical issues with our female doctors at our Bencoolen Branch and Robertson Branch.

Frequently Asked Questions (FAQs) on Vaginismus

There is no specific reason or cause for vaginismus. It is often linked to anxiety and a fear when it comes to sexual intercourse. Some women may have had a childhood history of sexual trauma or may come from a more conservative background. Nonetheless, in many women with vaginismus, it may be impossible to identify an underlying cause.

Women with vaginismus may experience pain or a burning discomfort during attempted intercourse. Depending on the severity of vaginismus, penetrative intercourse may even be unachievable.

Beyond discomfort during sexual intimacy, vaginismus may manifest in other ways, such as the inability to insert a tampon, or difficulty with pelvic examinations in the medical setting e.g. undergoing a PAP smear, during which the use of a vaginal speculum to open up the vaginal canal is necessary.

No, painful intercourse (medically knowns as “dyspareunia”) can be caused by many different reasons and vaginismus is only one. Other causes such as skin conditions, infections, vaginal atrophy or lack of lubrication can all cause painful intercourse.

The diagnosis of vaginismus is largely clinical, which means your doctor will talk to you and ask you to describe your symptoms in detail and then perform a thorough physical examination. This is also to ascertain that there are no other underlying medical condition contributing to the pain you experience. Other similar medical conditions may also masquerade as vaginismus but treatment may be very different.

In some cases, if your doctor has reason to think your symptoms could be due to another condition, additional investigations such as an ultrasound scan of the pelvis may be warranted.

Treatment for vaginismus is complex and must address not just the physical aspect but also any associated emotional or psychosexual and relational aspects. This is why treatment is multi-pronged and should involve both the woman and her partner (if there is one).

Treatment of the physical aspect of vaginismus is aimed at releasing the tension in the pelvic floor muscles. Desensitisation techniques are used in retraining of the pelvic floor muscles to teach them to relax, and to allow a woman to take conscious control and override the involuntary muscle spasms.

This is done through the use of vaginal dilators and pelvic floor exercises. These may be used together with medications to help one relax, and creams or gels to numb the vaginal area.

Botox injections administered through the vagina to the surrounding muscles is an experimental treatment which appears to have some good results but no real large-scale research to support it. This has to be done under sedation or general anaesthesia and is not routinely offered as initial treatment.

Some women and their partners may also find psychosexual and relationship counselling helpful during this journey.

Vaginal dilators are used to help with desensitisation. A set of vaginal dilators comes in gradually increasing sizes. These dilators are not meant to enlarge or stretch the vaginal opening, but rather, to desensitise the pelvic floor muscles.

The dilators are inserted either by yourself or together with the help of your partner, in the familiar environment of your own home, or in the clinic, starting with the smallest sized dilator in the set. As your pelvic floor muscles learn to relax more over time, you will be able to progress through using the various sized dilators in the set.

These dilators are often used in conjunction with a topical numbing cream or anaesthetic cream to make insertion more comfortable.

There is no set duration of time for treatment. Different women will take different amounts of time to get through the dilator set. It is important to remember not to push or compare oneself and feel discouraged- your journey to overcoming vaginismus is your own.

Vaginismus is treatable and pain-free sexual intercourse is achievable.